In this study the MoCA 5-min protocol was derived from the Hong Kong version of the MoCA. The MoCA 5-min protocol consists of four subtests examining five cognitive domains, including attention, verbal learning and memory, executive functions/language, and orientation. Study assessments were administered in the Cantonese language. Proxy consents (adult children for four patients, spouse for one) were obtained in patients with dementia who lacked capacity to give informed consent.

Approval from the CUHK-NTEC Ethics Committee was obtained for the STRIDE study and all patients gave written informed consent for participation. Patients had adequate sensorimotor and language capacity to complete cognitive testing, as determined at entry into the STRIDE study. 9 Patients with moderate or severe dementia, as defined by CDR ≥2, were excluded. In the current substudy, participants were selected through stratified random sampling by cognitive status based on Clinical Dementia Rating (CDR). Patients with prestroke dementia were excluded from the STRIDE study. Participants are patients with stroke or TIA recruited in the ongoing STroke Registry Investigating Cognitive DEcline (STRIDE) study, 8 which is an ongoing 5 year longitudinal study to evaluate the rate and predictors of delayed cognitive decline in a consecutive cohort of 1,013 patients (mean age 69.6 44% female) admitted to a major regional hospital in Hong Kong for stroke and TIA between 20. The objective of this study is to examine the validity and reliability of the MoCA 5-min protocol administered over the telephone. 4, 7 In accordance to the structure of the 5-minute protocol proposed by the NINDS-CNS Harmonization workshop, we constructed the MoCA 5-min protocol by extracting four subtests from the MoCA. There are at least three abbreviated versions of the MoCA that has been developed and examined in stroke patients ( table 1). It is also too lengthy (∼15 minutes) to be used as a very brief screen. 3- 6 However, its paper-and-pencil test format requires the examinee be physically present for examination. It is valid and reliable in the patients with VCI including stroke, subarachnoid hemorrhage and stroke-free persons with vascular risk factors. The Montreal Cognitive Assessment (MoCA) has been recommended as a clinical screening instrument for VCI. homebound) and to support telemedicine stroke service and large epidemiological and clinical research.

1 The latter protocol aims to increase access for cognitive assessment for patients living in remote areas or for those not able to attend clinical follow up for various reasons (e.g. The 60-minute protocol and the 30-minute protocols were designed for detailed cognitive profiling and clinical screening, whereas a very brief protocol (∼5 minutes) was proposed to serve as a screen at bedside, busy clinics and over the telephone.

In 2005, the National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN) VCI Harmonization Working Group recommended a set of three neuropsychological protocols to serve different purposes in VCI assessment. Screening instruments for VCI should be sensitive to mild impairment and neuropsychological features of VCI. 1, 2 Cognitive assessment is integral in the diagnosis and management of VCI. It is common in the aging population and is particularly prevalent in patients with stroke. Vascular cognitive impairment (VCI) refers to cognitive dysfunction with an underlying vascular etiology.

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